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Value-Based Healthcare in Practice: IDEATE, a Collaboration to Design and Test an Outcomes-Based Agreement for a Medicine in Wales

Jessica R. Burton Orcid Logo, Kate Halsby, Graciela Sáinz de la Fuente, Jonathan Pearson-Stuttard, Rebecca Sloan, Thomas Porter, Gareth John, Andrew Warburton, Jennifer Selby, Gail Povey, Ruhe Chowdhury, Catherine Bale, Mark Davies, Emma Clifton-Brown, Hamish Laing Orcid Logo

PharmacoEconomics, Volume: 43, Issue: 2, Pages: 191 - 207

Swansea University Author: Hamish Laing Orcid Logo

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DOI (Published version): 10.1007/s40273-024-01445-0

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Objective: To develop a sustainable, scalable methodology for the design of outcome-based agreements (OBAs) that works on the ground and dynamically overcomes historical challenges. Methods: Project IDEATE co-created solutions to known (and emergent) challenges via iterative workshops and real-world...

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Published in: PharmacoEconomics
ISSN: 1170-7690 1179-2027
Published: Springer Science and Business Media LLC 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa68519
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Methods: Project IDEATE co-created solutions to known (and emergent) challenges via iterative workshops and real-world data analysis to develop and refine a hypothetical model for an OBA in a trusted research environment. A cross-disciplinary collaboration between National Health Service (NHS) Wales, industry and academia was developed. Data were collected from Welsh national datasets and used to construct a novel linked dataset. OBA scenarios, with different contract parameters, were analysed to assess impact on the proportion of contract payment due and the volatility of payments. Results: An approved, in market, locally advanced and metastatic breast cancer treatment was selected as the test case. The total number of patients in the treatment cohort (2017-2020) was n = 99, and 286 in the control cohort (2014-2016). The final outcome variables selected were: (1) 1-year survival,( 2) intolerance to treatment (deferral), and (3) the total days disrupted by care. The primary scenario included all three outcomes measured at the population level and used a linear payment model. Volatility analyses demonstrated contract parameters can dramatically alter the contract output with greatest risk from a single, binary outcome contract design. Conclusion: The design of an OBA is a complex process that requires a multi-disciplinary approach. By assessing solutions to data, outcomes and contracting challenges, IDEATE provides a strong foundation for future success of OBAs in the UK. Plain Language Summary: Outcome-based agreements (OBAs) are a way to pay for medicines if they help patient&#xA0;health in a specific way over time. These agreements can make it faster for people to get new medicines, but they also have challenges, like needing a lot of time and effort to manage them. A team from the NHS Wales, life sciences, and Swansea University created Project IDEATE to find a better way to design OBAs and solve some of these problems. Welsh datasets were used to create a new breast cancer dataset to test different OBAs and see how payments would change. A breast cancer treatment was used for the project. The project had 99 patients who got the medicine (2017-2020) and 286 patients who had breast cancer but did not get the medicine (2014-2016). Three health outcomes were measured: (1) living for one year after treatment, (2) patients needing to stop the medicine, and (3) days spent in care. The main OBA option we tested used all three health outcomes; the more the outcomes improved, the more the payments could go up until they hit the highest amount agreed. The analysis showed that the way an OBA is designed can make a big difference in how stable or risky it is, especially if one of&#xA0;the health outcomes has only two options. 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spelling 2025-02-06T14:04:25.5095190 v2 68519 2024-12-10 Value-Based Healthcare in Practice: IDEATE, a Collaboration to Design and Test an Outcomes-Based Agreement for a Medicine in Wales be60df55bc8e44cf2aacf7230876588d 0000-0002-5661-7937 Hamish Laing Hamish Laing true false 2024-12-10 CBAE Objective: To develop a sustainable, scalable methodology for the design of outcome-based agreements (OBAs) that works on the ground and dynamically overcomes historical challenges. Methods: Project IDEATE co-created solutions to known (and emergent) challenges via iterative workshops and real-world data analysis to develop and refine a hypothetical model for an OBA in a trusted research environment. A cross-disciplinary collaboration between National Health Service (NHS) Wales, industry and academia was developed. Data were collected from Welsh national datasets and used to construct a novel linked dataset. OBA scenarios, with different contract parameters, were analysed to assess impact on the proportion of contract payment due and the volatility of payments. Results: An approved, in market, locally advanced and metastatic breast cancer treatment was selected as the test case. The total number of patients in the treatment cohort (2017-2020) was n = 99, and 286 in the control cohort (2014-2016). The final outcome variables selected were: (1) 1-year survival,( 2) intolerance to treatment (deferral), and (3) the total days disrupted by care. The primary scenario included all three outcomes measured at the population level and used a linear payment model. Volatility analyses demonstrated contract parameters can dramatically alter the contract output with greatest risk from a single, binary outcome contract design. Conclusion: The design of an OBA is a complex process that requires a multi-disciplinary approach. By assessing solutions to data, outcomes and contracting challenges, IDEATE provides a strong foundation for future success of OBAs in the UK. Plain Language Summary: Outcome-based agreements (OBAs) are a way to pay for medicines if they help patient health in a specific way over time. These agreements can make it faster for people to get new medicines, but they also have challenges, like needing a lot of time and effort to manage them. A team from the NHS Wales, life sciences, and Swansea University created Project IDEATE to find a better way to design OBAs and solve some of these problems. Welsh datasets were used to create a new breast cancer dataset to test different OBAs and see how payments would change. A breast cancer treatment was used for the project. The project had 99 patients who got the medicine (2017-2020) and 286 patients who had breast cancer but did not get the medicine (2014-2016). Three health outcomes were measured: (1) living for one year after treatment, (2) patients needing to stop the medicine, and (3) days spent in care. The main OBA option we tested used all three health outcomes; the more the outcomes improved, the more the payments could go up until they hit the highest amount agreed. The analysis showed that the way an OBA is designed can make a big difference in how stable or risky it is, especially if one of the health outcomes has only two options. Project IDEATE showed that making an OBA can be hard, but when people from different fields work together, they can overcome many challenges and succeed. Journal Article PharmacoEconomics 43 2 191 207 Springer Science and Business Media LLC 1170-7690 1179-2027 1 2 2025 2025-02-01 10.1007/s40273-024-01445-0 COLLEGE NANME Management School COLLEGE CODE CBAE Swansea University External research funder(s) paid the OA fee (includes OA grants disbursed by the Library) Pfizer Ltd. funded this study and the open access fees, including funding for the collaboration with Lane Clark & Peacock LLP. Pfizer Ltd. is the sponsor of the study. No specific grant or award funded this research. 2025-02-06T14:04:25.5095190 2024-12-10T13:57:22.5491378 Faculty of Humanities and Social Sciences School of Management - Business Management Jessica R. Burton 0009-0004-9115-8782 1 Kate Halsby 2 Graciela Sáinz de la Fuente 3 Jonathan Pearson-Stuttard 4 Rebecca Sloan 5 Thomas Porter 6 Gareth John 7 Andrew Warburton 8 Jennifer Selby 9 Gail Povey 10 Ruhe Chowdhury 11 Catherine Bale 12 Mark Davies 13 Emma Clifton-Brown 14 Hamish Laing 0000-0002-5661-7937 15 68519__33101__57339d38f8b24244872a0241abadda61.pdf 68519.VOR.pdf 2024-12-10T14:03:31.3824025 Output 1165304 application/pdf Version of Record true © The Author(s) 2024. Open Access. This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0). true eng http://creativecommons.org/licenses/by-nc/4.0/
title Value-Based Healthcare in Practice: IDEATE, a Collaboration to Design and Test an Outcomes-Based Agreement for a Medicine in Wales
spellingShingle Value-Based Healthcare in Practice: IDEATE, a Collaboration to Design and Test an Outcomes-Based Agreement for a Medicine in Wales
Hamish Laing
title_short Value-Based Healthcare in Practice: IDEATE, a Collaboration to Design and Test an Outcomes-Based Agreement for a Medicine in Wales
title_full Value-Based Healthcare in Practice: IDEATE, a Collaboration to Design and Test an Outcomes-Based Agreement for a Medicine in Wales
title_fullStr Value-Based Healthcare in Practice: IDEATE, a Collaboration to Design and Test an Outcomes-Based Agreement for a Medicine in Wales
title_full_unstemmed Value-Based Healthcare in Practice: IDEATE, a Collaboration to Design and Test an Outcomes-Based Agreement for a Medicine in Wales
title_sort Value-Based Healthcare in Practice: IDEATE, a Collaboration to Design and Test an Outcomes-Based Agreement for a Medicine in Wales
author_id_str_mv be60df55bc8e44cf2aacf7230876588d
author_id_fullname_str_mv be60df55bc8e44cf2aacf7230876588d_***_Hamish Laing
author Hamish Laing
author2 Jessica R. Burton
Kate Halsby
Graciela Sáinz de la Fuente
Jonathan Pearson-Stuttard
Rebecca Sloan
Thomas Porter
Gareth John
Andrew Warburton
Jennifer Selby
Gail Povey
Ruhe Chowdhury
Catherine Bale
Mark Davies
Emma Clifton-Brown
Hamish Laing
format Journal article
container_title PharmacoEconomics
container_volume 43
container_issue 2
container_start_page 191
publishDate 2025
institution Swansea University
issn 1170-7690
1179-2027
doi_str_mv 10.1007/s40273-024-01445-0
publisher Springer Science and Business Media LLC
college_str Faculty of Humanities and Social Sciences
hierarchytype
hierarchy_top_id facultyofhumanitiesandsocialsciences
hierarchy_top_title Faculty of Humanities and Social Sciences
hierarchy_parent_id facultyofhumanitiesandsocialsciences
hierarchy_parent_title Faculty of Humanities and Social Sciences
department_str School of Management - Business Management{{{_:::_}}}Faculty of Humanities and Social Sciences{{{_:::_}}}School of Management - Business Management
document_store_str 1
active_str 0
description Objective: To develop a sustainable, scalable methodology for the design of outcome-based agreements (OBAs) that works on the ground and dynamically overcomes historical challenges. Methods: Project IDEATE co-created solutions to known (and emergent) challenges via iterative workshops and real-world data analysis to develop and refine a hypothetical model for an OBA in a trusted research environment. A cross-disciplinary collaboration between National Health Service (NHS) Wales, industry and academia was developed. Data were collected from Welsh national datasets and used to construct a novel linked dataset. OBA scenarios, with different contract parameters, were analysed to assess impact on the proportion of contract payment due and the volatility of payments. Results: An approved, in market, locally advanced and metastatic breast cancer treatment was selected as the test case. The total number of patients in the treatment cohort (2017-2020) was n = 99, and 286 in the control cohort (2014-2016). The final outcome variables selected were: (1) 1-year survival,( 2) intolerance to treatment (deferral), and (3) the total days disrupted by care. The primary scenario included all three outcomes measured at the population level and used a linear payment model. Volatility analyses demonstrated contract parameters can dramatically alter the contract output with greatest risk from a single, binary outcome contract design. Conclusion: The design of an OBA is a complex process that requires a multi-disciplinary approach. By assessing solutions to data, outcomes and contracting challenges, IDEATE provides a strong foundation for future success of OBAs in the UK. Plain Language Summary: Outcome-based agreements (OBAs) are a way to pay for medicines if they help patient health in a specific way over time. These agreements can make it faster for people to get new medicines, but they also have challenges, like needing a lot of time and effort to manage them. A team from the NHS Wales, life sciences, and Swansea University created Project IDEATE to find a better way to design OBAs and solve some of these problems. Welsh datasets were used to create a new breast cancer dataset to test different OBAs and see how payments would change. A breast cancer treatment was used for the project. The project had 99 patients who got the medicine (2017-2020) and 286 patients who had breast cancer but did not get the medicine (2014-2016). Three health outcomes were measured: (1) living for one year after treatment, (2) patients needing to stop the medicine, and (3) days spent in care. The main OBA option we tested used all three health outcomes; the more the outcomes improved, the more the payments could go up until they hit the highest amount agreed. The analysis showed that the way an OBA is designed can make a big difference in how stable or risky it is, especially if one of the health outcomes has only two options. Project IDEATE showed that making an OBA can be hard, but when people from different fields work together, they can overcome many challenges and succeed.
published_date 2025-02-01T08:18:18Z
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